Author: Meghan BakerAnthony HarriesChristie JeonJessica HartAnil KapurKnut LonnrothSalah-Eddine OttmaniSunali GoonesekeraMegan Murray
Credits/Source: BMC Medicine 2011, 9:81
Multiple studies of tuberculosis treatment have indicated that patients with diabetes mellitus may experience poor outcomes.We performed a systematic review and meta-analysis to quantitatively summarize evidence for the impact of diabetes on tuberculosis outcomes.
Methods:
We searched PubMed, EMBASE and the World Health Organization Regional Indexes from January 1, 1980 to December 31, 2010 and references of relevant articles for reports of observational studies that included people with diabetes treated for tuberculosis. We reviewed the full text of 742 papers and included 33 studies of which 9 reported culture conversion at 2-3 months, 12 reported the combined outcome of failure and death, 23 reported death, 4 reported death adjusted for age and other potential confounding factors, 5 reported relapse, and 4 reported drug resistant recurrent tuberculosis.
Results:
Diabetes is associated with an increased risk of failure and death during tuberculosis treatment.
Patients with diabetes have a risk ratio (RR) for the combined outcome of failure and death of 1.69 (95% CI, 1.36-2.12). The RR of death during tuberculosis treatment among the 23 unadjusted studies is 1.89 (95% CI, 1.52-2.36), and this increased to an effect estimate of 4.95 (95% CI, 2.69-9.10) among the 4 studies that adjusted for age and other potential confounding factors.
Diabetes is also associated with an increased risk of relapse (RR, 3.89; 95% CI, 2.43-6.23). We did not find evidence for an increased risk of tuberculosis recurrence with drug resistant strains among people with diabetes.
The studies assessing sputum culture conversion after two to three months of tuberculosis therapy were heterogeneous with relative risks that ranged from 0.79 to 3.25.
Conclusions:
Diabetes increases the risk of failure and death combined, death, and relapse among patients with tuberculosis. This study highlights a need for increased attention to treatment of tuberculosis in people with diabetes, which may include testing for suspected diabetes, improved glucose control, and increased clinical and therapeutic monitoring.
http://7thspace.com/headlines/388027/the_impact_of_diabetes_on_tuberculosis_treatment_outcomes_a_systematic_review.html
Showing posts with label diabetes with tuberculosis. Show all posts
Showing posts with label diabetes with tuberculosis. Show all posts
Thursday, 7 July 2011
Monday, 6 June 2011
TUBERCULOSIS: Patients with diabetes at high risk for developing tuberculosis
June 3, 2011
Restrepo BI. Bull World Health Organ. 2011;89:352-359.
The risk for contracting tuberculosis is three to five times higher for patients with diabetes compared with those without the disease, according to researchers at the University of Texas Health Science Center at Houston.
“With diabetes on the rise in [tuberculosis]-endemic areas, our findings highlight the re-emerging impact of diabetes … on [tuberculosis] control in regions of the world where both diseases are prevalent,” the researchers wrote in their study.
Blanca Restrepo, PhD, associate professor of epidemiology at University of Texas School of Public Health, Brownsville Regional Campus, and colleagues enrolled 233 patients with probable tuberculosis (TB) between March 2006 and September 2008 at TB clinics in South Texas and northeastern Mexico. The purpose of the study was to estimate the risk for TB attributable to diabetes in those living along the Mexican border. They used primary data from patients with newly diagnosed TB who were tested for diabetes, according to the study.
The prevalence of diabetes was higher among patients with TB vs. the general population in South Texas (39.3% vs. 19.5%) and northeastern Mexico (36% vs. 15.1%). The researchers estimated that patients with diabetes had three times the risk for developing TB compared with those without diabetes, and that risk was five times higher for those aged 35 to 64 years. In patients aged at least 20 years, the estimated fraction of TB cases attributable to diabetes was 26% in South Texas and 24% in northeastern Mexico. The rate increased to 48% among people aged between 35 and 64 years living in South Texas. Across the population, the fraction of TB cases attributable to diabetes was 63% in South Texas and 68% in northeastern Mexico.
According to the researchers, almost all of the patients with diabetes were aware of their diabetes disease status at least 6 months before TB diagnosis.
“These findings reveal that diabetic patients with TB are not new to the health care system and highlight the fact that opportunities for preventing TB among diabetes patients are often missed,” the researchers wrote. “While not all diabetes patients with latent TB infection should take prophylactic treatment, such patients should be made aware of their risk of TB and should discuss with their physicians the potential risks and benefits of taking preventive anti-TB treatment.”
http://www.endocrinetoday.com/view.aspx?rid=84310
Restrepo BI. Bull World Health Organ. 2011;89:352-359.
The risk for contracting tuberculosis is three to five times higher for patients with diabetes compared with those without the disease, according to researchers at the University of Texas Health Science Center at Houston.
“With diabetes on the rise in [tuberculosis]-endemic areas, our findings highlight the re-emerging impact of diabetes … on [tuberculosis] control in regions of the world where both diseases are prevalent,” the researchers wrote in their study.
Blanca Restrepo, PhD, associate professor of epidemiology at University of Texas School of Public Health, Brownsville Regional Campus, and colleagues enrolled 233 patients with probable tuberculosis (TB) between March 2006 and September 2008 at TB clinics in South Texas and northeastern Mexico. The purpose of the study was to estimate the risk for TB attributable to diabetes in those living along the Mexican border. They used primary data from patients with newly diagnosed TB who were tested for diabetes, according to the study.
The prevalence of diabetes was higher among patients with TB vs. the general population in South Texas (39.3% vs. 19.5%) and northeastern Mexico (36% vs. 15.1%). The researchers estimated that patients with diabetes had three times the risk for developing TB compared with those without diabetes, and that risk was five times higher for those aged 35 to 64 years. In patients aged at least 20 years, the estimated fraction of TB cases attributable to diabetes was 26% in South Texas and 24% in northeastern Mexico. The rate increased to 48% among people aged between 35 and 64 years living in South Texas. Across the population, the fraction of TB cases attributable to diabetes was 63% in South Texas and 68% in northeastern Mexico.
According to the researchers, almost all of the patients with diabetes were aware of their diabetes disease status at least 6 months before TB diagnosis.
“These findings reveal that diabetic patients with TB are not new to the health care system and highlight the fact that opportunities for preventing TB among diabetes patients are often missed,” the researchers wrote. “While not all diabetes patients with latent TB infection should take prophylactic treatment, such patients should be made aware of their risk of TB and should discuss with their physicians the potential risks and benefits of taking preventive anti-TB treatment.”
http://www.endocrinetoday.com/view.aspx?rid=84310
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